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Introduction: Overweight and obesity has become a worldwide epidemic and is a growing public health concern. The increase in prevalence and severity of obesity among children and adolescents has been attributed largely to behavioral factors such as changing eating habits and sedentary lifestyles. Objective: To determine prevalence of obesity and abdominal obesity among adolescents and its association with sociodemographic factors and lifestyle. Methods: Present cross-sectional study was conducted in the urban field practice area under the Community Medicine Department of LLRM Medical College, Meerut, among 872 adolescents. All localities in the field area were covered and house to house survey was done. Questions were asked about eating patterns, physical activity and sedentary lifestyle. Data was collected and analyzed using appropriate statistical tests. Results: The prevalence of overweight and obesity was 17.43, 6.88%, respectively. Obesity was significantly higher among females, those who indulged in unhealthy eating habits were physically inactive, watched television for a longer duration and ate junk while watching television. Conclusion: In the present study, we found that high junk food consumption and a sedentary lifestyle were found to be significantly associated with childhood overweight/obesity. As a result, timely interventions should be taken to improve awareness about healthy lifestyle behavior to prevent obesity and its complications among adolescents.
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Most common population at risk for both symptomatic urinary tract infection (UTI) and asymptomatic bacteriuria, however, is sexually active women. Although asymptomatic infection in this group does not clearly produce serious medical problems, it may be a predictor of future symptomatic infection. Women are more susceptible to infection than men because of the shorter length of the female urethra. Perineal bacterial microbiota that originate in the gastrointestinal tract are the usual pathogens, especially if the bacteria possess factors that facilitate their binding to the uroepithelium. Sexual intercourse facilitates entry of the bacteria into the female urethra. Pregnant women are extra at risk of expand UTIs due to physiological adjustments withinside the urinary tract. UTI constitute severe threats to human health worldwide and hundreds of thousands of the humans affected every year. The aim of this study was to know the prevalence and antimicrobial susceptibility pattern of isolates in pregnant female patients. A total two hundred pregnant and non-pregnant females patients had been included on this study after obtaining the consent. Under strict aseptic precautions midstream urine samples had been taken from all sufferers. All the samples had been processed with the aid of using the usage of standard bacteriological methods i.e. wet mount, inoculation on blood agar and MacConkey's agar after which diagnosed with the aid of using standard biochemical tests, antibiotic sensitivity trying out changed into completed with the aid of using Kirby Bauer's disc diffusion method. In this study 80 out of 200 females patient i.e. 40% were showed UTI of which a most of 20 to 30 years age group had a considerably better occurrence of UTI i.e. 56.25%, while the age group of 60 years and above suggests the lowest contamination rate i.e 2.5% as compared to others. Females belonging to lower socioeconomic status had been extra liable to UTI then others. Pregnant females were more prone to UTI then non-pregnant females i.e. 52.73% and 35.17% respectively. Amongst pregnant females, primigravida and those in the first and second trimesters had been at higher risk. All isolates had been sensitivity to ampicillin+sulbactam, sparfloxacin, and gatifloxacin. Our study mentioned that the prevalence of UTIs was 40%; the pregnant female patients were more prone to UTI than non-pregnant females. The most isolated microorganism had been Escherichia coli which was maximum accountable for UTIs. The sexually active age group 26-30 years was highly at risk of UTI. Females belonging to lower socioeconomic status had been extra liable to contamination. Pregnancy was one in each of the predisposing elements for UTI. All isolates had been confirmed sensitivity to ampicillin+sulbactam, sparfloxacin, and gatifloxacin.
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Background: Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana has been launched to provide financial protection expenditure to nearly 500 million vulnerable Indians. For expanding the coverage under the scheme, it is necessary to understand the perspective of health care service providers involved in the scheme. Aim & Objective: To find out the bottlenecks in implementation of PMJAY scheme using empanelled hospitals’ perspective Settings and Design: Cross sectional study Methods and Material: 8 Public and 23 Private hospitals were selected through Simple Random Sampling from the list of PMJAY empanelled hospitals. The PMJAY Medical Officer co-ordinators in the empanelled hospitals were interviewed using a predesigned and pretested questionnaire. Statistical analysis used: Data was analysed using descriptive statistics in Epiinfo software. Results: Among the 31 empanelled hospitals studied, 93.5% were satisfied with the process for empanelment under PMJAY. 64.5% hospitals were not satisfied with the Health Benefit Packages. 77.4% hospitals perceived the PMJAY to be poorer as compared to private health insurance with reasons being poor grievance reprisal, poor claim processing and settlement, denial of reimbursement of health packages, poor rates of health packages and little information about the scheme. Conclusions: Various hurdles are being faced in the implementation of the scheme. There definitely remains a huge scope for further improvements so as to enhance the insurance coverage in the country.
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Background: Infants and pre-school are most susceptible to undernutrition. Integrated Child Development Services is the programme focussing undernourished children by providing them supplementary nutrition. Aim& Objective: To study prevalence of undernutrition in 0-6 year old children and to study factors associated with it. To study impact of supplementary nutrition on undernourished children. Settings and Design: A longitudinal study. Methods and Material: The present longitudinal study was conducted in randomly selected Anganwadis of urban Meerut. Children found to be suffering from under nutrition were followed up at interval of six months to see the impact of supplementary nutrition provided to them at the anganwadi centre. A detailed history of relevant underlying factors responsible for causation of under nutrition were taken from mothers of these children. Statistical analysis used: chi square test was used to find out association between risk factors and undernutrition. Risk factor found statistically significant were further analysed using step wise multiple logistic regression analysis. The impact of supplementary nutrition was assessed using paired t test. Results: Iron folic acid supplementation during pregnancy, exclusive breast feeding in children, immunization and time of initiating complementary feed were found statistically significant on both chi-square and multiple logistic regression analysis. No impact of supplementary nutrition was found on anthropometric measurements of children. Conclusions: The main focus for fighting undernutrition in children (0-6 years) should be on preventing risk factors associated with mothers in antenatal period and during child rearing practices
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Background: The most common teaching method in medical institutes in India and throughout the globe is standard lesson-based teaching. E-learning is the use of internet technology to facilitate conscious learning and increase knowledge and competences, notably during the COVID-19 epidemic. Aim and Objectives: The aim of study was to develop a module for an interactive disease-based e-learning teaching session to impart knowledge to undergraduate medical students regarding the microbiological diagnostic techniques for enteric fever/the given organism with objectives of the study was (i) to investigate how Phase II MBBS students feel about e-learning; (ii) to evaluate the impact of this intervention on students; and (iii) to encourage application of this imparted knowledge and skill for rapid, precise, and early diagnosis of the disease. Material and Methods: The research was conducted at the department of microbiology. This was done for the session 2020–2021 of Phase II undergraduate students. All the second professional MBBS were enrolled in the study n = 229 and were better informed about the definition of e-learning. The course material was provided in the form of PowerPoint presentations, questionnaires, and text questions using Google Docs. Students provided feedback in the form of a semi-structured pre-validated set of questions at the conclusion of the week, and the collected data were quantitatively analyzed. There were both closed-ended and open-ended questions in the survey. Results: The results of the feedback questionnaire revealed that the program was of benefit to the students. Nearly 77% of students felt the new teaching and learning method enhanced their grasp of the courses and that the issues presented were important to them. Conclusion: The students responded in a positive way to the new teaching and learning method. It was informative, applicable, and effective to the students. It also increased the level of communication and feedback between teacher and students. To conclude, in the medical program, e-resources may be used to enhance conventional lesson-based instruction.
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Background: - COVID-19 is the most important public health problem of recent time. Many people require hospitalization after infection. COVID vaccination is the most effective way to prevent the disease. Due to extensive negative publicity through social media channels/platforms,significant number of individuals are not coming forward for vaccination. Therefore, study is needed to evaluate adverse effects associated with different vaccines available in India. Objectives: - To assess the adverse effects associated with COVID-19 vaccination and compare the side effect of two most commonly used COVID vaccines in India. Methods:- In the current report, a cross sectional study was conducted among beneficiaries of COVID-19 vaccines at the vaccination center of the LLRM Medical college, India. After institutional ethical clearance and informed consent, patients were asked about the symptoms they experienced after vaccination. A very simple random sampling approach was used to select beneficiaries. Information was collected on predesigned Google form and total 391 patients submitted the responses. Results:- Out of total respondents 77 % individuals reported one or more symptoms. Fever was reported to be most common problem (59.3%) followed by body ache (57.5%). Out of total beneficiaries, 68.3% experienced mild symptoms while 23% remain asymptomatic. Only few subjects reported moderate adverse effects (8.7%). None of the respondent reported severe and serious adverse effect. Conclusions:- Vaccine associated adverse effects were found less than 3 days and of mild variety in most of the beneficiaries. There was no difference in adverse effect profile of two commonly used vaccines in India. People must come forward for vaccination in mass without fearing of adverse effects of vaccines.
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Background: Diabetes is an insidious public health problem. India has the second largest number of adults living with diabetes worldwide (77 million). Indian Diabetes Risk Score (IDRS) is a simple, cost-effective and feasible tool for mass screening programme at community level. Aim & Objective: To assess diabetes risk in adults aged 30 years and above and to identify high risk subjects for screening undiagnosed diabetes in an urban population of Meerut. Settings and Design: Community based cross-sectional study. Methods and Material: All adults who were ?30 years of age and non-diabetic were interviewed using pre-designed, pre-tested questionnaire for their socio-demographic profile and lifestyle. Fasting Blood glucose of all study subjects were done to screen undiagnosed diabetics. Statistical analysis used: Centers for Disease Control (CDC), Epi Info TM 7.2.3.1 was used. Pearson’s Chi Square were applied. Results: 33.4% were found to have high diabetes risk. Risk of diabetes increases with age. 7.6% of the study subjects were found to be diabetic and were unaware of their diabetic status. Physical inactivity and increasing waist circumference were found to be significantly associated with risk of diabetes. Diabetes risk was also significantly associated with positive family history. Conclusions: Screening and early identification of high risk individuals would help in early diagnosis and treatment to prevent or to delay the onset of diabetes mellitus and its complications.
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To synthesize a series of ornidazole thiosemicarbazone analogues on the basis of literature reviews of 2-Methyl-5-nitroimidazoles and thiosemicarbazones and to evaluate all the analogues in vitro for their activity against Aspergillus niger and fumigatus. Thiosemicarbazone analogues were synthesized from oxidising ornidazole with potassium dichromate and refluxing the oxidised product with substituted thiosemicarbazide using ethanol as solvent in the acidic medium overnight. All the synthesized analogues of ornidazole showed good antifungal action against fumigatus and niger except compound C-4. Unsubstituted amine analogue C-2 has shown highest percentage inhibition (96.6%, 500 μg/ml) against fumigatus while aromatic amine with or without electronegative atom analogues C-3 and C-5 has shown highest activity against Aspergillus niger which is two times than standard drug ornidazole (100%, 1000 μg/ml).
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Pediatric small round cell tumors (PSRCTs) constitute a large proportion of childhood malignancies with overlapping diagnostic and clinical features but radically different therapies. Here, we report a case of 16-year-old male child presenting with diffuse abdominal and mediastinal mass, axillary lymphadenopathy, and pleural effusion. Bone marrow aspirate showed near total replacement by small round malignant cells. The bone marrow biopsy showed interstitial infiltration by malignant cells, which were CD45? CD3? CD20? MIC2+ FLI1+ and diagnosis of Ewing's sarcoma was established. In contrast, flowcytometric immunophenotyping of the bone marrow aspirate showed CD45? cells, which were CD19+ cytCD79a+ CD10+ CD81+ CD38+ HLA-DR+ CD22+ CD20? consistent with B-cell acute lymphoblastic leukemia (B-ALL). The extended immunostaining panel on bone marrow biopsy also showed positivity for cytCD79a, CD10, CD19, and BCL-2, whereas fluorescent in-situ hybridization for EWSR1 gene rearrangement was negative. Thus, a final diagnosis of CD45? FLI1+ MIC2+ B-ALL was established. Rare cases of CD45? B-ALL with immunoreactivity for MIC2 and Friend leukemia virus integration 1 (FLI1) have posed a diagnostic challenge for PSRCTs in the recent past. This case report highlights the role of multimodality approach in establishing a correct diagnosis in CD45? PSRCTs to ensure definitive therapy and better clinical outcome.
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Background: Major determinant of dengue incidence is interaction between ecology, vector bionomics, and social factors. Objectives: The objective of the study is to find out bio-eco-social determinants of Aedes breeding. Methods: Background, household, entomological, and knowledge, attitude, and practice (KAP) surveys were undertaken post- and premonsoon showers from May to June 2016 in urban and rural practice area of medical college. Results: A total of 181 and 204 households, 131 and 137 individuals, and 1250 and 1268 water-holding containers were included in household survey, KAP survey, and larval survey in urban slum and rural area, respectively. In both locations, maximum water-holding containers were indoors (41.4% and 61.8%, respectively); however, maximum positivity was peridomestic (63.6% and 83.1%, respectively). Pupae per container were 0.9 and 1.9 in respective locations and pupae per person were 1.2 and 2.3, respectively. Container positivity was seen in containers with rain as water source (8.8%) as well as among those who were never used (10.7%). Irregular water supply was significantly more in rural area (P < 0.05). KAP survey revealed that majority (90.1% and 71.5%, respectively) had heard about dengue, with significantly higher knowledge in urban slum, and television was the main source of information. Majority (89% and 83%, respectively) were unaware that peak biting time of Aedes is daytime. Use of mosquito repellent coils was the predominant preventive practice (46.6% and 61.2%, respectively). Pupae were reared; all were found to be Aedes aegypti. Conclusions: Despite enhanced awareness campaigns, an integrated vector management approach is required for prevention of dengue.
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Background: The International Headache Society (IHS), 2013 defined Cervicogenic Headache (CGH) as a secondary headache, which implies that headache is caused by a disorder of the cervical spine and its components bony, disc and soft tissue elements. CGH can be a perplexing pain disorder that is refractory to treatment if it is perceived. Patients with CGH exhibited decreases in the quality of life comparable to migraine-patients and patients with tension-type headache, with even lower scores for physical functioning. The objective of the study is to see the effectiveness of PRT versus ischemic compression on pressure pain threshold, range of motion, and headache disability in CGH patients. Methods: Total of 60 patients of CGH was taken based on inclusion and exclusion criteria, who were divided into three groups, i.e., PRT GROUP A, Ischemic Compression GROUP B, and CONTROL group GROUP C. Group A received PRT, Group B received Ischemic Compression and Group C received conventional treatment 3 sessions per week for 4 weeks. Results: Significant reduction in Headache disability followed by improved physical functioning measured by Headache disability index, improvement in Pressure pain threshold and measured by Pressure algometer and Range of motion measured by Universal goniometer in the group who received Positional release technique along with conventional treatment. (p < 0.05) Therefore, it is suggested that the Positional release technique reduces Headache disability, Improves Pressure pain threshold and range of motion in college-going students with Cervicogenic headache. Conclusion: PRT is an effective approach to improve the Pressure pain threshold, Headache disability, and Range of motion, thus improving the patient's physical functioning.
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Aim: A pharmacoeconomic analysis to determine the relative cost-effectiveness of timolol 0.5%, brinzolamide 1% and brimonidine 0.2% eye drops in treatment of Primary Open Angle Glaucoma (POAG)/ocular hypertension (OHT). Settings and Design: Comparative, open, randomized, parallel group prospective study. Materials and Methods: 60 patients of POAG or ocular hypertension were included in this study. Time period of study was 6 weeks. 60 eyes of 60 patients were included in the study. Patients were divided randomly into 3 groups of 20 each. Patients in group A, B and C received timolol, brinzolamide and brimonidine respectively. One drop of each medication was instilled twice a day at 9 am and 9 pm daily for 6 weeks. IOP was measured on day 0 at 9 am (before administration of drugs) and then at 11 am, to get baseline IOP. IOP was again measured on subsequent visits at 9 am and 11 am. Treatment outcome was number of mm Hg fall in IOP induced by the study drug. The daily cost of each drug was calculated by maximum retail price and the average number of drops per bottle. The cost‑effectiveness was then calculated as the cost of drug/mm Hg fall in IOP. Statistics: Paired ‘t’ test was used to analyze the parameters within the group. Independent samples t‑test was used to compare the efficacy of drugs with each other. Results: The % reduction of brimonidine, timolol and brinzolamide at end of 6 weeks was 21.43 ± 3.06%, 24.87 ± 2.46% and 18.78 ± 1.73% respectively. Timolol was superior in efficacy to other two drugs. The difference was statistically significant between the efficacy of timolol and brinzolamide (p < 0.001) as well as timolol and brimonidine (p = 0.003). There was no statistical significant difference in the efficacy of brimonidine when compared to brinzolamide (p=0.26). Timolol (5.87 ± 0.83 Rs/mm lowering after 6 weeks) was found to be most cost-effective followed by brimonidine (46.83 ± 7.37) and then brinzolamide (60.49 ± 6.77) in lowering IOP. Conclusion: All three drugs under the present study are useful in the treatment of POAG/OHT, but timolol is a better choice than other two drugs because of greater reduction in IOP and greater cost-effectiveness.
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According to the World Health Organization, between 8% and 38% of health workers suffer physical violence at some point in their careers. This multicentric study was conducted to find the prevalence, perceived risk factors, and measures to prevent workplace violence among doctors. The sample consisted of all 2nd- and 3rd-year resident doctors (n = 305) from three colleges in Uttar Pradesh. An anonymous, pretested in a similar setting, self-administered questionnaire was used. 69.5% of doctors reported to have experienced violence in one or other form in the past 1 year. In most incidents, relatives and attendants (69.3%) were involved in violence. No action was taken immediately in regard to violence in 35.3% of instances; 60.3% of study participants reported that they had repeated disturbing memories, thoughts, or images of the attack. Nonavailability of medicines (38.6%) and less staff (36.7%) were cited as top reasons behind violence.
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Shone complex is an extremely rare and severe congenital heart disease characterized by left -heart obstruction at multiple levels namely supravalvular mitral ring, parachute mitral valve, subaortic stenosis and coarctation of the aorta. We in the present case describe a patient of shone complex who underwent successful coarctoplasty with the help of BIB (balloon in balloon) dilatation catheter and covered CP (cheatham platinum) stent. The role of interventional cardiologist is to diagnose and choose the right approach for the specific patient, whether surgery, balloon or stent.
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Recent scientific evidence suggests there is high prevalence of Vitamin D deficiency in India. There is paucity of scientific data on Vitamin D status in population residing at high altitude regions in India. Hence, the present study was undertaken to determine Vitamin D status of adult population residing at altitude of 4000 meter and above in Himachal Pradesh, India.
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There has been an increase in the consumption of junk food (JF) among school-aged children (SAC) possibly leading to obesity and diet-related diseases among them. We do not have evidence on consumption of JF in rural areas; hence, we conducted a study to assess the consumption of JF by SAC in rural, Himachal Pradesh. A total of 425 children in the age group of 12� years studying in 30 government schools (clusters) were included. The clusters were selected using population proportionate to size sampling methodology. We found high prevalence (36%) of consumption of JF among SAC during the last 24 h. Efforts should be taken to reduce the consumption of JF by promotion of healthy dietary habits and educating children about the ill effects of JF.
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Background: Intestinal parasitism(IP) remains a common problem in school going children. Aims & Objectives: To study the prevalence IP infestation in school going children and to study the relation with type of water supply and sanitation. Material and Methods: A cross sectional study was carried out and a total of 461 stool samples were collected from children under ten years of age from various schools of Rishikesh. The normal saline and iodine mounts of fresh and saturated salt solution concentrated samples were examined. Modified Ziehl Neelsen staining was done for detection of coccidian parasites. The statistical significance within gender, age, drinking water supply, sanitation and other socio-demographic parameters was assessed by Chi-square test. Results: 112 (24.3%) out of 461 were positive for intestinal parasites. Giardia lamblia was the commonest parasite (15.2%) followed by Hymenolepis nana (2.38%), Hookworm (2.17%), Enterobius vermicularis (2.17%), Entamoeba histolytica (2.17%), Ascaris lumbricoides (0.86%), and Cryptosporidium parvum (0.86%). Conclusions: Due to lack of proper sanitation & education along with low socioeconomic background, IP infections are still prevalent among school children. Regular awareness program on promoting good health, maintenance of proper personal hygiene and carrying out regular deworming in schools should be instituted for control.
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Background: Adolescent obesity is becoming a major public health problem in urban areas of India and its prevalence is increasing in all socioeconomic groups irrespective of religion, region and caste. Aims & Objectives: To find out prevalence of overweight & obesity among adolescents and to study its association with sociodemographic factors. Material & Methods: This cross-sectional study was carried out in the area covered by Urban Health and Training Centre of Lala Lajpat Rai Memorial Medical College, Meerut. Sample size was estimated by keeping the prevalence as 10% with 95% confidence interval and relative precision of 20%. A total of 872 adolescents were selected randomly using proportional allocation method. Results: The prevalence of overweight was found to be 17.4% and obesity 6.9%. The prevalence was significantly higher among females and in those belonging to nuclear families as well as higher socioeconomic status. Conclusion: The prevalence of overweight and obesity is quite high in the urban area and there is a need to develop an effective programme for the prevention of obesity in these areas.
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Background: Staphylococcus aureus is one of the top six most common etiologic agents of nosocomial, community and livestock acquired bacterial infections. These infections although initially were described as a major problem in hospitals have now also become a serious threat in community not only in India but also worldwide. Its prevalence varies depending on the health-care setting, country or a particular region. Thus to better understand the epidemiology of methicillin-resistant S. aureus (MRSA) in a particular geographical location, it is important to study the variations in the population using molecular tools. Methods: This prospective study was carried out in the Department of Microbiology of Shree Guru Gobind Singh Tricentenary (SGT) Medical College. Staphylococcal protein A (spa) typing was done on 250 S. aureus isolates obtained from various clinical specimens including pus, wound swabs, urine, catheters, blood and cerebrosspinal fluid from both indoor and outdoor patients of SGT Hospital, Budhera, Gurgaon. Results: The selected region of the spa gene of all 250 isolates which includes 87 MRSA and 163 methicillin-susceptible S. aureus were amplified. The spa gene was detected in 248 out of 250 isolates (99.2%), whereas in 2 isolates (0.8%), it remained undetected and referred as non-typable isolates. The 248 S. aureus isolates were typed into 39 spa types, which clustered into six different spa clonal clusters and eight singletons. Conclusion: High diversity observed within S. aureus isolates indicated that many different strains circulate in the study region or in the hospital. The results would contribute in the understanding of epidemiology related to S. aureus spread and prevention.